TORONTO - A self-styled cosmetic surgeon who carried on doing a liposuction procedure even though a post-operative patient was dying in a room next door has lost her licence for two years.
In handing down the penalty on Wednesday, Ontario's medical regulator also ordered Dr. Behnaz Yazdanfar to pay $219,000 in costs and face a public reprimand in light of the death and misery she inflicted on other patients.
"(Yazdanfar's) lack of knowledge and/or ability, and her faulty judgment ended in tragic consequences," the College of Physicians and Surgeons of Ontario said in its decision.
"She violated her professional responsibility by treating not just one but many patients in an unsafe manner."
Yazdanfar, a family doctor who moved exclusively into liposuction and breast augmentation in 2003, was found to have violated professional standards last May in regard to numerous patients.
In one case, Krista Stryland, 32, died after Yazdanfar removed more than six litres of fat from over 30 per cent of her body -- well above the five-litre maximum standard -- which was "frankly dangerous," college documents show.
When Stryland went into shock, Yazdanfar failed to respond properly, the college said. The owner and operator of the Toronto Cosmetic Clinic went to perform another procedure as Stryland lay dying in the recovery room.
"Standing by and failing to call 911 when appropriate in the Krista Stryland case demonstrated that she was not up to the task of caring for this critically ill patient," the college found.
It took more than hour after Stryland collapsed before an ambulance was called to the clinic.
"The call to 911 was her only meaningful contribution to the resuscitation effort, and it was done too late," college documents state.
When they finally arrived, paramedics found Stryland ashen and lying in a pool of pink fluid. She died shortly after in hospital.
In another case, Francine Mendelson, 66, was sent home bleeding and in pain with her elderly husband just hours after major liposuction.
Her son, a veterinarian, put it this way:
"I couldn't imagine how a human doctor could possibly discharge a patient in this state."
Ultimately, her recovery took as long as nine months, according to college records.
Other patients were sent home by themselves in taxis when it was risky to do so, the college found.
In imposing the licence suspension, the disciplinary committee said it was "particularly troubled by Dr. Yazdanfar's failure to take responsibility for her actions" and said she routinely disregarded basic patient safety.
It found her own assessment of her skills to be deficient and troubling.
"The committee was shocked to hear her equating her experience with a six-year residency program," the panel said.
Her errors in judgment "spanned her practice" and were not isolated cases, according to the panel, which found problems with more than two dozen patient charts.
The college found issues with how the doctor communicated the risks of procedures, which cost thousands of dollars each, to prospective patients, routinely extracted too much fat at once, and how she advertised her clinic.
After her suspension, Yazdanfar will be allowed to practise as an assistant in a hospital-based setting.
She will also have to allow random inspections of her practice and patient charts.
Dr. Bruce Liberman, Yazdanfar's anesthesiologist who also committed professional, misconduct has yet to be punished.
The college, in recent years, has tightened the rules around doctors who do cosmetic surgery and its inspections of non-hospital clinics.